If you cannot swallow your own saliva, are vomiting blood, or passing black tarry stools, seek emergency care now. Complete obstruction and bleeding are emergencies. Also seek urgent care for severe chest or abdominal pain with fever.
Cancers of the food pipe and stomach. Both frequently present when swallowing becomes difficult or weight has already been lost, which makes nutrition part of the treatment rather than an afterthought.
The most common error in these cancers is going straight to surgery. For most patients, chemotherapy before the operation produces a better outcome — and that decision has to be made before the operation, not after it.
Oesophageal cancer arises in the food pipe. Squamous cell carcinoma occurs mainly in the upper and middle portions and is linked to tobacco, alcohol and very hot drinks. Adenocarcinoma occurs at the lower end near the junction with the stomach and is associated with long-standing acid reflux and Barrett's oesophagus.
Gastric cancer arises in the stomach itself, and chronic infection with Helicobacter pylori is a major contributor along with diet high in salted and preserved foods. Treating H. pylori reduces risk, which is why testing family members is worth considering.
Both tend to present late, because early symptoms are vague and dismissed as indigestion. By the time swallowing becomes difficult, the tumour is usually substantial. This makes staging particularly important — a considerable proportion of patients turn out to have spread that is not visible on CT alone.
Nutrition deserves emphasis. Patients who lose significant weight before surgery do worse afterwards, and correcting nutrition before an operation is not a delay — it is preparation that improves the result.
For most resectable stomach and oesophageal cancers, giving chemotherapy — or chemoradiotherapy in oesophageal cancer — before surgery improves outcomes compared with surgery alone. This sequence is standard in high-volume centres and is frequently omitted elsewhere. Once the tumour has been removed, the opportunity to give treatment beforehand has gone. If surgery has been proposed as the immediate first step, that is worth a second opinion before you consent.
Endoscopy makes the diagnosis; several tests together establish whether surgery is appropriate.
A short keyhole procedure before major surgery detects small deposits on the peritoneal surface that no scan can see. Where these are found, a large and difficult operation that would not have helped is avoided, and treatment is redirected. It is standard in high-volume centres for gastric cancer and frequently omitted elsewhere. Ask whether it is planned.
Sequence matters more here than in most cancers, and nutrition runs alongside everything.
Several cycles before the operation to shrink the tumour and treat microscopic spread, then surgery, then further cycles afterwards. This approach is standard for most resectable gastric and junctional cancers and produces better outcomes than surgery alone.
For oesophageal cancer, radiotherapy given with chemotherapy before the operation improves the chance of complete removal and improves survival. It requires several weeks of daily radiotherapy, which must be given in India.
Removal of the tumour with adequate margins and the surrounding lymph nodes — a partial or total gastrectomy, or removal of part of the oesophagus with reconstruction using the stomach. These are major operations, and outcomes correlate strongly with how many the surgical team performs each year.
Where surgery is not possible, chemotherapy with targeted therapy where HER2 is positive, and immunotherapy in selected patients, can control disease and relieve symptoms. A stent placed endoscopically can restore swallowing quickly, and feeding tubes maintain nutrition during treatment.
PET-CT and, for gastric cancer, staging laparoscopy answer this. Peritoneal spread changes the plan completely and is invisible on standard scans.
Chemotherapy or chemoradiotherapy before surgery is standard for most resectable disease. This decision must be made before the operation.
Significant weight loss before major upper gastrointestinal surgery worsens outcomes. Correcting it first is part of the treatment plan, not a delay to it.
Ask the surgeon how many gastrectomies or oesophagectomies their team performs each year. In these two operations the relationship between volume and outcome is among the strongest in surgery.
Complete obstruction of the food pipe needs relieving locally — often with a stent — before travel. Arriving unable to swallow and severely malnourished makes everything that follows harder.
Photographs taken on your phone are fine. Reports in Arabic, Russian or Bengali are fine — we translate them ourselves.
For most stomach and oesophageal cancers, no — chemotherapy or chemoradiotherapy before surgery produces better outcomes than surgery alone. This is standard practice in high-volume centres and is often omitted elsewhere. If immediate surgery has been proposed, it is worth a second opinion before you agree.
It is a short keyhole procedure to look inside the abdomen before committing to major surgery. It detects small deposits on the peritoneal surface that no scan can see, and where they are found it spares the patient a large operation that would not have helped. For gastric cancer it is standard in good centres.
Differently, but adequately in most cases. After removal of part or all of the stomach you will need smaller, more frequent meals, and vitamin B12 supplementation is usually required for life after a total gastrectomy. A dietitian should be part of your care from before the operation, not after it.
Yes. A stent placed at endoscopy can restore swallowing within a day, and this can be done in your own country. Where a stent is not appropriate, a feeding tube maintains nutrition while treatment is planned. Do not travel while unable to swallow — get it relieved locally first.
It can. Chronic H. pylori infection is a significant risk factor for stomach cancer, and where a family member has had gastric cancer, testing and treating close relatives is reasonable. It is a simple test and a short course of antibiotics.
If chemotherapy is given before surgery, some cycles can often be given at home, and you travel for the operation. For oesophageal cancer requiring chemoradiotherapy first, the radiotherapy course must be given here — plan on around ten to twelve weeks in total. We will map out exactly which parts need to be in India.
Send the endoscopy report, the biopsy pathology and the CT. Tell us your current weight and what it was six months ago — nutrition changes the plan.
Your reports go directly to our medical team. We do not share your records with hospitals until you tell us to.
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